Purpose: To investigate the prevalence and associated factors of fundus tessellation in highly myopic children and adolescents. Methods: A total of 513 high myopes (spherical equivalent [SE] ≤ À5.0 D, 4-19 years of age) without any advanced pathological myopic lesions were enrolled. Fundus photographs and choroidal thickness (ChT) data were collected by SS-OCT. A novel grading approach was adopted to classify fundus tessellation into four categories on colour fundus photography, referring to the location of tessellation divided by an Early Treatment Diabetic Retinopathy Study grid centred on the fovea, through which closer to the fovea represents higher grades of fundus tessellation. Peripapillary atrophy (PPA) area and ovality index were also measured. Results: Among the participants, with a mean age of 13.47 AE 3.13 years and mean SE of À 8.34 AE 1.91 D, there were 29 (5.7%), 95 (18.5%), 233 (45.4%) and 156 (30.4%) participants with grade 0 to grade 3 fundus tessellation, respectively. The ChT in both the macular and peripapillary area was negatively correlated with the fundus tessellation grade (R = À0.763 and À0.537, respectively, all p < 0.001). Higher grades of fundus tessellation were independently associated with thinner macular ChT (
This study aimed to explore the morphological characteristics of Bruch's membrane opening distance (BMOD), border length (BL), border tissue angle (BTA), vertical tilt angle, and peripapillary atrophy (PPA), as well as their associations with choroidal thickness (ChT) in young healthy highly myopic eyes. METHODS. A total of 167 patients with high myopia and 172 individuals without high myopia were enrolled. All of the subjects were divided by axial length. The PPA area was measured on fundus photographs. BMOD, BL, BTA, vertical tilt angle, macular ChT (mChT), and peripapillary ChT (pChT) were measured on swept-source optical coherence tomography scans. RESULTS. The PPA area (P < 0.0001) and vertical tilt angle (P < 0.0001) were larger, BMOD (P < 0.0001) and BL (P < 0.0001) were longer, and BTA (P < 0.0001) was smaller in the high-myopia group compared with the group without high myopia. Every 1-μm increase in BMOD was associated with a 35.80-μm decrease in mChT; every 1°decrease in BTA was correlated with a 0.32-μm decrease in mChT and a 0.26-μm decrease in pChT; and no association was found between PPA area and ChT in the multivariate linear regression model. CONCLUSIONS. PPA area, BL, BMOD, and vertical tilt angle increased, but BTA decreased with axial elongation of the globe in young, healthy patients with myopia. Longer BMOD was positively correlated with lower mChT, and smaller BTA was positively correlated with lower mChT and pChT in this population.
Purpose: To construct quantifiable models of imaging features by machine learning describing early changes of optic disc and peripapillary region, and to explore their performance as early indicators for choroidal thickness (ChT) in young myopic patients.Methods: Eight hundred and ninety six subjects were enrolled. Imaging features were extracted from fundus photographs. Macular ChT (mChT) and peripapillary ChT (pChT) were measured on swept-source optical coherence tomography scans. All participants were divided randomly into training (70%) and test (30%) sets. Imaging features correlated with ChT were selected by LASSO regression and combined into new indicators of optic disc (IODs) for mChT (IOD_mChT) and for pChT (IOD_pChT) by multivariate regression models in the training set. The performance of IODs was evaluated in the test set.Results: A significant correlation between IOD_mChT and mChT (r = 0.650, R2 = 0.423, P < 0.001) was found in the test set. IOD_mChT was negatively associated with axial length (AL) (r = −0.562, P < 0.001) and peripapillary atrophy (PPA) area (r = −0.738, P < 0.001) and positively associated with ovality index (r = 0.503, P < 0.001) and torsion angle (r = 0.242, P < 0.001) in the test set. Every 1 × 10 μm decrease in IOD_mChT was associated with an 8.87 μm decrease in mChT. A significant correlation between IOD_pChT and pChT (r = 0.576, R2 = 0.331, P < 0.001) was found in the test set. IOD_pChT was negatively associated with AL (r = −0.478, P < 0.001) and PPA area (r = −0.651, P < 0.001) and positively associated with ovality index (r = 0.285, P < 0.001) and torsion angle (r = 0.180, P < 0.001) in the test set. Every 1 × 10 μm decrease in IOD_pChT was associated with a 9.64 μm decrease in pChT.Conclusions: The study introduced a machine learning approach to acquire imaging information of early changes of optic disc and peripapillary region and constructed quantitative models significantly correlated with choroidal thickness. The objective models from fundus photographs represented a new approach that offset limitations of human annotation and could be applied in other areas of fundus diseases.
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